BY JIM HOWE

Janet Bacon‘s breast cancer is rare in one way, but typical in another: It shows the importance of early detection.

Bacon, 59, of Syracuse, had skipped her annual mammogram in 2014 – she had let a lot of things slide that year after losing her best friend.

In 2015, a resident health advocate – someone trained by Upstate to help neighbors find medical information and promote health – called Bacon to ask whether she had gotten that annual mammogram to screen for breast cancer, as part of the She Matters program (see
"How to obtain a mammogram," below).

“So I went for it,” Bacon says of the mammogram she got in March 2015. “I didn‘t think anything of it. They called me back for an ultrasound. About a week later, they said I needed a biopsy. I didn‘t think anything of that, either,” she says, noting she had been called back for a biopsy years ago that amounted to nothing.

This time was different.

“It was cancer. I was devastated. I couldn‘t speak at first,” she says.

She was diagnosed with ductal carcinoma in situ, found very early, at stage zero. This would normally be treated with a lumpectomy – surgical removal of the cancerous tissue, not the whole breast – followed by whole-breast radiation to prevent recurrence.

But Bacon‘s case was unusual – so much so that her doctors plan to publish a case study of it. She has scleroderma, a complicated, chronic disease of the connective tissue that has also affected her kidneys.

Radiation can cause scarring in people with scleroderma, so that would tend to rule out the usual treatment, says Bacon‘s radiation oncologist at Upstate, Anna Shapiro, MD.

“It would be a shame for her to have a mastectomy,” says Shapiro, but an operation to remove the entire breast was a likely alternative to avoid the radiation.

The multidisciplinary team at the Upstate Cancer Center decided, however, that a lumpectomy could be done if followed by a type of radiation called brachytherapy, which targets an area small enough to minimize the scarring.

Bacon‘s brachytherapy involved inserting tiny radioactive pieces through a tube into a balloon implanted at the lumpectomy site, twice daily for a week.

Brachytherapy is successful for a select group of patients, such as Bacon, who are generally at low risk for recurrence, Shapiro says.

Bacon feels fortunate not only for the care she received, but for her family, which includes a brother and six sisters living down South, as well as nieces and nephews, who came to lend support.

“They ran straight here to me the day I had surgery” in May 2015, she recalls. After the operation, her surgeon, Upstate‘s Scott Albert, MD, told her relatives in the waiting room that the operation was a success.

“He did a wonderful job,” Bacon says. Radiation treatment followed a month later, and a mammogram in October 2015 showed no trace of cancer.

Bacon has wasted no time in recommending regular mammograms to her female relatives, noting the family history of breast cancer includes not just herself but a niece who died of the disease.

Bacon says she is doing well, goes to routine check-ups every four months and will take anti-cancer medication for five years.

“I think breast cancer is my passion now. I don‘t want anyone to go through what I went through.” She says, “the No. 1 thing is getting a mammogram.” She adds she is consistent in reminding her neighbors to get a mammogram.

She is now a resident health advocate herself and  works to keep her 300 or so neighbors in the Toomey Abbott Towers on Almond Street informed about their health, particularly through She Matters programs.

Shapiro echoes the need for mammograms and outreach programs like She Matters.

”The reason we‘re so successful at improving success in curing breast cancer is because we‘re able to diagnose it so early. The success story of breast cancer really lies in early detection. Typically a mammogram picks up something small,” Shapiro says.

Albert notes that Bacon‘s type of cancer is usually only picked up through a mammogram.

How to obtain a mammogram

The New York State Cancer Services Program offers breast, cervical and prostate cancer screening for residents who meet income eligibility and age requirements. Call 866-442-2262 for details.

In addition, may public health departments (check with the one in the county where you live) provide access to low-cost or no-cost mammography and other cancer screenings for people without health insurance coverage.

The Upstate Cancer Center‘s "She Matters" program makes mammography available to underserved women living in Syracuse Housing Authority locations in downtown Syracuse. The program includes education and awareness about the disease, as well as general wellness.

A recent grant of $25,000 – the latest in an ongoing effort from the Susan G. Komen Foundation‘s Central New York affiliate -- helps expand this outreach to include Toomey Abbott Towers, Pioneer Homes and Almus Olver Towers.

She Matters was founded in 2014 and receives support from the housing authority and several community and Upstate organizations and departments.

This article appears in the fall 2016 issue of Cancer Care magazine. Hear a radio interview/podcast about the She Matters program.